The aim of this study was to investigate relationships and differences between 2 scales assessing subject’s adaptative functioning. On the one hand, Axis V in the revised version of the Third Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM III-R) includes specific symptoms for each level of functioning described. On the other hand, the Psychosocial Aptitude Rating Scale (PARS) does not include clinical symptoms. A total of 78 psychiatric inpatients were rated independently with the 2 scales. The 2 ratings were correlated for the whole sample and for each diagnostic category. Diagnosis (Axis 1) explained 63.9% of the variance in the Global Assessment Functioning (GAF) Scale (Axis V) and only 23.8% in the Psychosocial Aptitude Rating Scale (PARS). Axis V is then made redundant by Axis 1 which is contrary to the aim of a multi-axial system. PARS describes aspects of the disorder that are distinct from clinical symptoms. These occupational and social aspects may be of great interest for a better overall evaluation of severity of mental disorders.

Density (Bmax) and affinity constant (Kd) values of tritiated imipramine binding sites were determined on platelets from patients suffering from major depression and from healthy, age-and sex-matched controls. Significantly lower Bmax values were found in the depressed patients, while the Kd values did not differ from those of controls. The results suggest that, in accordance with data from the literature, decrease in 3H-imipramine binding sites may be used as a state-dependent biological marker of depression in clinical practice.

We studied circadian thyrotropin (TSH) and prolactin (PRL) response to synthetic thyrotropin-releasing-hormone (protirelin) infusion (200μg IV) at 8 am and 11 pm in 35 drug-free inpatients with DSM III-R Major Depressive Episode and in 22 hospitalized controls. In each group, maximum TSH and PRL responses were lower at 8 am than at 11 pm. The difference between 11 pm-ΔTSH and 8 am-ΔJTSH (ΔΔTSH) was significantly lower in depressed patients compared to controls. No such blunting was observed in PRL responses to protirelin in depressed patients. In the overall population, TSH response to protirelin (ie8 am-ΔTSH, 11 pm-ΔTSH, ΔΔTSH) correlated significantly with TSH circadian parameters (ie mesor and amplitude). These correlations were also observed with PRL (except for ΔΔPRL). TSH mesor and amplitude were lower in depressives than in controls. In contrast, PRL mesor and amplitude were not significantly different between diagnostic groups. ΔΔTSH is thus a chronobiological refinement to the measure of thyroid axis dysfunction in major depression. The blunted TSH response to protirelin suggests that the TRH receptors of the pituitary thyrotrophs are hyposensitive in major depression.

The present study was carried out in 2 successive phases. In the first, 91 inpatients admitted for opioid dependence were evaluated. All were treated with α2-agonists during the withdrawal period. Shortly after admission, a urine sample was taken and analyzed (EMIT and GC/MS). The presence of the cocaine metabolite benzoilecgonine in urine was a predictor of dropout probability during hospitalization (P < 0.01). A second study on a sample of 612 inpatients later admitted for similar reasons was carried out according to a simpler protocol (using only EMIT) in order to replicate the previous results. Again, the presence of benzoilecgonine in urine indicated dropout probability (P = 0.00004). Thus, the use of cocaine prior to admission for a treatment of opiate withdrawal syndrome with α2-agonists seems to predict therapeutic failure.

Modafinil is a new psychotropic compound with central α1, adrenergic-stimulant activity in animals. In the present study, its pharmacological activity in man was evaluated in the sleep-deprivation induced psychomotor and cognitive impairment paradigm. This was a double-blind placebo-controlled study involving 12 healthy volunteers. Standard psychomotor and memory tasks were used, including critical flicker fusion frequency determination (CFF), choice reaction time and short- and long-term memory evaluation. Results revealed a clear antagonism by modafinil of the psychomotor and cognitive impairment induced by sleep-deprivation in most tasks 6 h after drug administration, and marginal effects 18 h after. These results therefore support a psychostimulant activity of modafinil in man.

Twenty five asymptomatic HIV-1 seropositive subjects were matched with 25 healthy seronegative low-risk individuals to evaluate emotional patterns. Seropositive subjects scored significantly higher, and an important emotional deficit was noticed. Sensation seeking subscores were significantly lower in the seropositive group.

Ten outpatients with panic disorder were treated over an 8 week-period with milnacipran, an antidepressant active on both noradrenergic and serotonergic systems, at a dose between 100 and 150 mg/d. Clinical assessments included the Hamilton Anxiety Scale and the Cottraux Rating Scale for phobias, panic attacks, and generalized anxiety. Results showed very significant improvements in the frequency and intensity of panic attacks and in the level of generalized anxiety. A good or excellent response was noted in 7 patients. Only 3 patients complained of side-effects, mostly of the digestive type. These promising results of milnacipran in panic disorder need to be confirmed in controlled studies.